586 posters, 8 topics, 23 sessions, 1,077 authors, 622 institutions

ISQua's 40th International Conference 2024

24th - 27th September 2024 | Istanbul, Türkiye

P123

Enabling scale-up implementation of Patients Safety Checklist in Surgery: Investigating implementation factors -activities, and possible -outcomes.

Preview of Enabling scale-up implementation of Patients Safety Checklist in Surgery: Investigating implementation factors -activities, and possible -outcomes.

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Poster Presenter

Hilde Valen WAEHLE

Authors

Hilde Valen Waehle, Kristin Harris, Anette Storesund, Stig Harthug, Randi J. Tangvik, Åshild Teigland Tepstad, Ann Kristin Sandsbakk Austarheim, Arvid Steinar Haugen

Affiliations

Haukeland University Hospital, 1Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway,2Department of Research and Development, Haukeland University Hospital, Bergen, Norway, 1Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, 4Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway,, 1Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway,2Department of Research and Development, Haukeland University Hospital, Bergen, Norway, 1Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway,, 1Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway, 5Centre for Nutrition, Faculty of Clinical Medicine, University of Bergen, Bergen, Norway,, 1Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway, 6Department of Clinical Nutrition, Haukeland University Hospital, Bergen, Norway,, 1Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway, 7Department of Nursing and Health Promotion Acute and Critical Illness, Oslo Metropolitan University, Oslo, Norway

Part of Topic

Patient Safety & Quality Improvement

Enabling scale-up implementation of Patients` Safety Checklist in surgery – investigating implementation mechanisms

HILDE VALEN WAEHLE1, 2, 3, KRISTIN HARRIS1, 4, ANETTE STORESUND1,2,4, STIG HARTHUG1 , RANDI J. TANGVIK1, 5, ÅSHILD TEIGLAND TEPSTAD1, 6, ANN KRISTIN SANDSBAKK AUSTARHEIM1, 7, ARVID STEINAR HAUGEN1, 7 on behalf of the PASC study investigators

1Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway,2Department of Research and Development, Haukeland University Hospital, Bergen, Norway,3 Department of Global Public Health And Primary Care, University of Bergen, Bergen, Norway, 4Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway, 5Centre for Nutrition, Faculty of Clinical Medicine, University of Bergen, Bergen, Norway, 6Department of Clinical Nutrition, Haukeland University Hospital, Bergen, Norway, 7Department of Nursing and Health Promotion Acute and Critical Illness, Oslo Metropolitan University, Oslo, Norway

INTRODUCTION

•Patient safety is a cornerstone of quality care delivery.

•Patients are often discarded from developing new safety processes, resulting in missed opportunities for initiative-taking engagement and error prevention.1

•A checklists for surgical patients (PASC) have been developed, validated, and its feasibility has been evaluated.2-4

•PASC consists of a PRE- and a POST surgery part.

•For potential patient safety outcomes to materialize, implementation mechanisms need to be identified and effectively addressed during the scale-up implementation process of PASC.

AIM

To investigate implementation enablers from patients’ and healthcare workers’ perspectives

METHOD

Study design: Stepped Wedge Cluster Randomized Controlled Trial including elective patients from seven surgical specialties from three Norwegian hospitals. Data on implementation enablers were collected from January 2022- March 2024:

Pre-intervention activities:

•Transformation of PASC (paper) to digital version (ePASC)

•Enabling ePASC reports in patients` Electronic HR

•Educational and information stakeholder meetings

•Mapping of roles and responsibilities along the different surgical pathways

•

Intervention experience interviews (N=69)

•9 Focus-group interviews with healthcare workers (N= 25)

•44 Individual in-depth interviews with surgical patients

PRELIMINARY RESULTS: Identified PASC/ePASC implementation enablers at:

Patient level:

•Justify the use of ePASC - a possibility, not a requirement.

•Ensure ePASC is received at the appropriate time, ideally before surgery.

•Set expectations of ePASC report review and assessment by care providers.

•Healthcare workers should drive the use of ePASC.

•Encourage healthcare workers to promote and discuss ePASC before admission and discharge.

•

Healthcare Worker (HCW) level:

•Adapt PASC/ePASC items to fit the local workflow.

•Ensure a multidisciplinary approach and collaboration.

•Build capacity at the organizational level for PASC/ePASC implementation.

•Monitor ePASC usage along with performance and quality care indicators

CONCLUSION

Possible PASC implementation outcomes (measured by):

Individual patient level: Degree of patient involvement by PASC/ePASC fidelity (items and parts of PASC utilisation).

Collaborative level: Interactive information exchange between patient and care-provider (work process fidelity/ patient satisfaction at individual- and surgical speciality-level).

System level: Patient ePASC reports as system feedback to improve organisational learning and improve quality of patient safety information.